tci Medicare Compliance & Reimbursement - 2006 Issue 24

HOSPITALS: Huge Increase In High-Level ED Visits Brings On Hospital Billing Scrutiney

Ed visits may see upcoding emergency soon.Emergency Department physicians and hospitals may be upcoding evaluation & management visits in the ED, according to one study.The number of high-level E/M services in the ED increased sharply from 2002 to 2004, a nationwide study of Medicare ED claims by American Hospital Directory found. For example, 24 percent of visits were billed at 99284 in 2004, up from just 20 percent in 2002. The shift may be due to hospital-specific factors, but also to a change in coding practices. The study is available at www.ahd.com/EMstudy060530.pdf. Separately...

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